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目的:应用荟萃分析评价血清癌胚抗原（CEA）、糖类抗原19-9（CA19-9）和CA242检测在结直肠癌机会性筛查中的应用价值。方法:检索Pubmed、Embase、Cochrane Library、中国知网、万方和维普数据库从建库至2023年10月关于CEA、CA19-9和CA242检测在结直肠癌筛查中应用的原始研究文献（1 205篇），经过筛选共34篇文献纳入研究。采用诊断准确性研究的质量评价工具（QUADAS-2）对文献进行质量评价，Stata17.0统计软件进行荟萃分析，Deek漏斗图检验文献发表偏倚。结果:纳入的34篇文献均为病例对照研究，荟萃分析结果显示CEA、CA19-9和CA242单独检测的诊断准确性和灵敏度均较低。综合受试者工作特征（sROC）曲线下面积（AUC）分别为0.62、0.63和0.73，灵敏度分别为0.42、0.27和0.36。CEA、CA19-9和CA242联合检测可明显提高诊断准确性和灵敏度［AUC：0.92（95% CI：0.89~0.94），灵敏度：0.75（95% CI：0.65~0.83）］，特异度略有下降［从0.95降至0.90（95% CI：0.87~0.93）］。Deek检验表明无发表偏倚。 结论:CEA+CA19-9+CA242联合检测可以提高诊断结直肠癌的准确性以及灵敏度，但考虑缺乏体检人群的研究，是否适用于体检人群的筛查尚待进一步研究证实。

Objective:To analyze the application value of serum carcinoembryonic antigen (CEA), carbohydrate antigen (CA)19-9 and CA242 in screening colorectal cancer with a meta-analysis.Methods:A literature search was conducted in the databases of Pubmed, Embase, Cochrane, CNKI, Wanfang and VIP to identify studies on applying CEA, CA19-9 and CA242 for detection of colorectal cancer from the establishment of the databases to October 2023. The Quality Evaluation Tool of Diagnostic Accuracy Studies (QUADAS-2) was used to evaluate the quality of the literature. Stata17.0 statistical software was used for meta-analysis. Deeks funnel plot was used to analyze publication bias.Results:A total of 34 articles of case-control studies met the criteria. Meta-analysis revealed that the diagnostic accuracy and sensitivity of CEA, CA19-9 and CA242 were all low, the area under the curve (AUC) of summary receiver operating characteristic curve was 0.62, 0.63 and 0.73, the sensitivity was 0.42, 0.27 and 0.36, respectively. The combined detection of CEA+CA19-9+CA242 significantly improved the pooled diagnostic accuracy (AUC: 0.92(95% CI: 0.89-0.94) and sensitivity: 0.75(95% CI: 0.65-0.83)), the specificity was mildly reduced (dropped from above 0.95 to 0.90(95% CI 0.87-0.93)). The Deek′s test indicated no publication bias. Conclusions:Combined detection of CEA+CA19-9+CA242 can significantly improve the diagnostic accuracy and sensitivity in screening colorectal cancer with a compromised specificity. However, due to the lack of data, whether it can meet the demand for opportunistic screening in the physical examination population needs to be confirmed.